Base MHIT plan explained: Is it enough, or do you still need a medical card?

Introduced under Bank Negara Malaysia’s (BNM) RESET Strategy, the base MHIT plan is part of a wider effort to improve the affordability and sustainability of medical insurance in Malaysia. The pilot phase is expected to start by the endof July 2026, with a nationwide rollout planned for early 2027.

What is the base MHIT plan?

The base MHIT plan is also known as MediAsas, and it is offered as a standalone medical insurance and takaful protection plan to improve access to additional healthcare options for Malaysians who can sustainably afford private healthcare coverage.

Contributors will have the option to use savings from their EPF Account Sejahtera to pay premiums for the base MHIT plan. This option is voluntary, and not compulsory.

There are two product options – MediAsas Teras and MediAsas Fleksi – both of which are not linked to investment products. Individuals up to age 70 may purchase the plan, with protection provided up to age 85.

1. MediAsas Teras (Standard Plan)

This plan is designed for individuals who do not currently have insurance or takaful protection for major healthcare expenditures, but who are able to afford private healthcare coverage. It offers lower out-of-pocket costs during hospitalisation, but comes with a higher monthly premium.

Annual policy limit:

An annual limit of RM100,000 will apply, and this limit will increase to RM150,000 for individuals aged above 60 years old. According to BNM, the limits are sufficient to cover 99% of treatment costs.

2. MediAsas Fleksi (Standard-plus Plan)

This plan is designed for individuals seeking more affordable options for their existing plans. Premiums will be lower for this plan, which pays for claims that exceed the deductible amount.

Under this plan, individuals will bear the costs of hospital bills up to the deductible amount in the event of hospitalisation, and the plan will pay any costs above that amount.

For the standard-plus plan, the deductible levels of between RM10,000 and RM15,000, are being considered.

Annual policy limit:

Higher coverage of RM300,000, with a higher deductible. It also serves as an ideal backstop against major medical events or surgeries.

Note: Final pricing will be confirmed before the nationwide implementation in January 2027. The pilot phase will run from end-July until October 2026.

Indicative target monthly premium for the standard and standard-plus MHIT plans

Note: These premium ranges are preliminary and intended to guide affordable premium levels. Final premium rates and the full details of final premium rates will be published before the launch of the base MHIT plan in 2027.

Co-payment by base MHIT plan policyholders

Both the Standard and Standard Plus plans will apply a two-tier co-payment structure that is designed to encourage individuals to optimise their healthcare choices.

• Tier 1 (“In-network” hospitals):

What are in-network hospitals? They refer to hospitals that demonstrate an appropriate use of resources aligned to best-practice, cost-efficient care models, and are committed to minimum standards of cost transparency and service levels.

• Tier 2 (”Out-of-network” hospitals):

Note: The plan covers single or multiple admissions which are due to the same or related cause, or any complications arising from it.

Now, let’s talk about medical cards.

A medical card usually covers hospital stays, surgeries, and treatments, so that you don’t have to pay out-of-pocket for healthcare costs. It allows you to be admitted to panel hospitals first, and your insurer or takaful provider settles the charges directly with the hospital. This helps with the payment process during a stressful time.

Do note that a medical card is not a payment card. It is convenient proof of your insurance coverage to confirm your eligibility for cashless admission.

Upon admission into a panel hospital, the policyholder needs to produce the medical card, and then the insurer pays for the covered medical expenses. This ensures that personal savings and retirement savings are not severely affected by medical emergencies.

The steps of using a medical card are simple. When you visit a panel hospital for treatment:

1. Present your physical/digital card at the hospital counter.

2. The hospital verifies your eligibility with the insurer.

3. Upon approval, you will be admitted (cashless).

4. After discharge, the bill goes to your insurer.

If you choose a non-panel hospital, you can still claim later, but you will need to pay first and then submit receipts for reimbursement.

Medical cards in Malaysia typically come in two forms, as a standalone medical plan or as a rider (attached to a main insurance policy).

What are the main differences between base MHIT and medical cards?

Ultimately, the choice between the two depends on your risk strategy. A base MHIT plan serves as an affordable entry point for essential, fundamental protection. Conversely, a medical insurance plan like GREAT Medic Shield 2, can lessen your worries of medical and hospitalisation bills, with reimbursement of up to RM150,000 depending on your selected plan, and no overall lifetime limit.

So, who is the base MHIT plan for?

The base MHIT plan is structured to address gaps in the insurance market, and is primarily designed for the following segments:

• Individuals without existing medical coverage

If you've never had a medical card, the base MHIT plan will offer an entry point, with predictable premiums.

• Former policyholders affected by premium price increases

If rising premiums pushed you to cancel a medical insurance policy, the base MHIT offers a route back in.

• Individuals with controlled pre-existing conditions

The base MHIT plan is structured to be transparent, to reflect a proportionate approach to managing risks associated with prior medical conditions, including mental health conditions. 

To further strengthen the protection, BNM is also considering the application of an overall moratorium on claims (“no look-back” provision) which will establish a period of continuous coverage after which insurers cannot deny claims on grounds of prior medical conditions.

• Retirees or near-retirees looking for predictable, stable coverage

The base MHIT plan provides senior citizens up to age 85 with a stable and predictable premium outlook, mitigating the risk of sudden premium surges late in life.

Who doesn't need the base MHIT plan?

• Anyone already covered by a comprehensive medical card with a high annual limit.
• Younger, healthy individuals who can likely get better value from other medical plans.

How to choose between the base MHIT plan and a medical card? Should you have both?

In most cases, you don’t need both if your existing policy is already comprehensive. Holding both means paying two sets of premiums for overlapping (not stacked) coverage. Insurance doesn't pay double just because you have two plans.

However, here’s a scenario where a combination could make sense:

• Use base MHIT plan as a bridge if you're between jobs or your employer cover has ended, while you shop for a full private plan.
• Use base MHIT plan for pre-existing conditions while maintaining a private plan for broader non-exclusion benefits, if your budget allows.

BNM's advice: Assess your needs, discover the options, and choose wisely. Don't just default to the base MHIT in Malaysia because it is government designed.

What about coverage for serious illness?

One of the more common mistakes is to assume that a medical card solves everything. A medical card usually covers your hospital bills. It pays for the surgeon, the room, and the ICU monitor.

But what happens if you are diagnosed with a severe condition? Who pays your rent, your car loan, and your groceries while you are on medical leave for six months and unable to work?

That is why financial planners usually recommend a 3-layer protection framework:

1. The medical card: Pays hospital and treatment bills

2. Critical illness protection: Pays a lump sum when you are diagnosed with a major illness. You can use the money for anything, such as paying household bills, hiring a caretaker, or getting alternative treatments.

3. Life insurance: A financial safety net that ensures your family is taken care of if the absolute worst happens.

Not sure which plan is right for you? Here's where to start.

The base MHIT plan is a step in the right direction for Malaysians who don’t have insurance coverage. But it's not a replacement for a comprehensive medical plan if you can afford one. Coverage limits matter. The gap between RM100,000 and RM5 million in annual protection is not trivial when you are facing a serious illness.

Whether you're comparing plans for the first time, reevaluating your current policies, or looking to fill a gap in your existing coverage, the best move is to understand what you actually have and need.

Explore Great Eastern Malaysia's medical and health plans 

Choosing the right plan means matching your life stage to the right level of coverage. Our products bridge the gap between basic government-driven coverage and more comprehensive plans, from standalone medical cards to investment-linked riders for retirement. Here are a few that you can explore.

• Standalone medical card: We offer several standalone medical cards, including the GREAT Medic Shield 2 for comprehensive annual protection up to RM150,000, and the GREAT Health Direct plan for coverage up to age 80.
• Medical insurance riders: There are medical insurance riders that cover hospitalisation, surgery, and advanced treatments, such as GREAT MediValue, SMART Health Protector, and SMARTMedic Shield.
• GREAT Critical Care plans: Critical illness covers like Smart Multi Critical Care covers up to 188 conditions, and multiple claims are allowed across early to advanced stages of the critical illness benefit.

Not sure where to start? Talk to a Great Eastern Life Planning Advisor to assess your budget and build a protection portfolio that keeps you covered for life. Alternatively, check out the Great Eastern Health & Medical Insurance page
to compare features of available plans.